Scenarios (All Topics)
Hyperglycemic Hyperosmolar State (HHS)
A life-threatening complication of Type 2 Diabetes characterized by severe hyperglycemia, hyperosmolality, and dehydration without significant ketosis.
Clinical Presentation
- Blood glucose >600 mg/dL
- Profound dehydration and dry mucous membranes
- Altered mental status or seizures
- Absence of Kussmaul respirations
Nursing Priorities
- Administer IV fluid resuscitation with 0.9% Normal Saline
- Administer regular insulin via IV infusion
- Monitor serum potassium closely, as insulin shifts K+ intracellularly
Monitoring
- Hourly blood glucose checks
- Continuous cardiac monitoring for dysrhythmias
- Neurological status assessment every hour
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